What you should know about cardiac extrasystoles

Cardiology specialists define an extrasystole as a very common and generally benign heart rhythm disturbance, also known as a premature heartbeat.

Under normal conditions, a point at the back of the heart, known as the sinus node, initiates cell depolarization, which is transmitted by a specific conduction system to all the muscle fibers and generates cardiac contraction; this situation is repeated in each cardiac cycle, giving rise to a regular and stable rhythm known as sinus rhythm. It is common, however, for some impulses to originate at a point other than the sinus node, generating a premature contraction and physiological compensation in the next beat to keep the amount of blood leaving the heart stable.

Symptoms of extrasystole

The perception of this rhythm disturbance differs from person to person. Often it is asymptomatic; other times it is described as a sensation of a flipping sensation at the level of the heart or as a more intense beat that comes earlier and is followed by another beat after a longer than usual pause.

The time of day when it appears is also unpredictable, with relaxation phases being one of the periods when it is most noticeable.

How is it studied?

During the physical examination it is possible to detect with auscultation a slight abnormality in the cardiac rhythm, which is confirmed with an electrocardiogram.

The beat shows a characteristic figure, whose morphology depends on the point where the extrasystole is generated. When the beats are more isolated, the rate holter is the test of choice, since it allows us to study the heart rhythm and quantify the number of extrasystoles throughout the day.

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Doppler echocardiography is also recommended: it is useful to study the cardiac structures, since, although it is generally a benign process, in some cases it may be the first manifestation of an underlying heart disease.

How to treat extrasystoles

Most patients do not require treatment and extrasystole is a transient process with periods of greater or lesser exacerbation. Pharmacological treatment is used in the most symptomatic cases, with the beta-blocker family (propranolol, bisoprololol and atenolol) being the most commonly used. In general, it is also recommended that excitatory substances such as coffee, tobacco and alcohol be avoided.